WHITE LICHENOID LESIONS OF THE BUCCAL MUCOSA IN PATIENTS WITH HIV-INFECTION

We report on eight patients who developed white lichenoid lesions of t he buccal mucosa during the course of human immunodeficiency virus inf ection. In five patients the lesions appeared after the administration of zidovudine, in two after the intake of both zidovudine and ketocon azole, and in one after ketoconazole. In the majority of cases, lesion s presented as bilateral reticular keratosis or atrophic changes of th e buccal mucosa. Three patients manifested lichenoid atrophic changes of the dorsum of the tongue. The histopathologic features were hyperke ratosis, epithelial atrophy, basal cell liquefaction, and the presence in the lamina propria of either a patchy or diffuse lymphocytic infil trate. All specimens tested negative for Epstein-Barr virus and human papillomavirus. Our study suggests that lichenoid lesions of the bucca l mucosa, similar-to what has been described as lichenoid drug reactio ns or idiopathic lichen planus, can be observed during human immunodef iciency virus infection and that administration of zidovudine and keto conazole should be considered as a possible cause.